Talking about cancer is often difficult for people of all ages. At a time when you are dealing with your own fears and expectations of what lies ahead, it is important to help your grandchildren understand and cope with the situation.

Trying to protect your grandchildren by not sharing information about your illness may cause them to rely on imagination or fantasy, rather than fact, regardless of their ages. In many instances, children's assumptions may be worse than reality. Telling them the truth by providing age-appropriate information helps build a relationship based on trust. Being honest with your grandchildren will help them feel less isolated, and it will give you all the opportunity to support each other.

Tips for talking with your grandchildren

Anticipate your grandchildren's reaction. The impression your cancer diagnosis will have on your grandchildren will depend on various factors:

The children's ages and maturity levels

Your role in their lives (For example, some grandparents are primary caregivers[3] for their grandchildren.)

The distance you live from your grandchildren

The children's previous experience with another family member or friend who has been diagnosed with cancer

The parents' ways of coping with cancer

Find the right time. Seek the advice and support of the children's parents to help you decide the right time to have an open discussion about your cancer diagnosis. This gives the parents advance notice, allowing them to develop strategies to help children cope with the life changes they may experience in the future. Consider asking the children's parents to be present when you talk with your grandchildren to support both you and the children.

In addition, address your own emotional reaction to your cancer diagnosis before talking with your grandchildren. This may allow you to better focus on communicating with sensitivity and responding to the children's reactions to the news.

Find the right words. You may need to sit down with other family members and friends to prepare your explanation. Specifically, ask the children's parents for advice about how much information the children can handle and what language they are planning to use with the children to maintain consistency (example: “cancer” versus “leukemia”; “port-a-cath” versus “tube for medicine”). Considering potential questions that your grandchildren may ask will help you prepare answers.

The amount of information you share should depend on your grandchildren's ages and levels of maturity, as well as their current coping skills. For example, younger children may not grasp the concept of cancer or understand complex words or phrases. In these cases, it is best to use simple language or draw pictures to describe what is happening. Older children, in contrast, may require a more detailed explanation. Begin with simple explanations, and try not to present the information in an overwhelming way. Learn more about how children understand cancer[4] and how to talk with children about cancer[5].

Remaining as calm as possible when you talk about your cancer diagnosis will reassure your grandchildren.

Help your grandchildren understand physical effects of cancer and treatment. You may have times when you don't feel well or you experience sudden changes in your physical appearance, such as hair loss and weight loss. These changes may frighten your grandchildren if they haven't been told what to expect. As you explain, remember that children may confuse the side effects of treatment with the symptoms or signs of the cancer, thinking that your cancer is getting worse as you experience treatment side effects. Explain that, although the treatment may have some difficult side effects, it is ultimately working to help you get better. Learn more about your type of cancer[6] and coping with specific side effects[7].

Encourage them to express their feelings. Your grandchildren may experience many emotions, such as sadness, anxiety, fear, guilt, and anger. Encouraging them to talk with you and their parents about how they are feeling will let them know that it is okay to have these feelings. In addition, sharing your feelings with them will let them know they are not alone. Try to remain optimistic without being misleading, and reassure them that your love for them remains the same.

Welcome questions. Let your grandchildren know that they are free to ask any question. However, remember to provide age-appropriate information in response. Younger children may need time to think about what has been said before asking for clarification. When they have questions, be honest, and don't be afraid to say that you don't know the answer. You can tell them that you will ask your doctor and get back to them with an answer as soon as possible. In addition, encourage your grandchildren to tell you what they hear from other sources about cancer to check for accuracy.

Address changes in the family routine. If you are a primary caregiver for your grandchildren, try to maintain their routines as much as possible, but acknowledge that some things will be different.

Young children may fear being separated from you, especially if you are typically present in most of their daily routines. Tell them in advance if you will be away for several days or for a few hours each morning so that they will not feel like they are being abandoned. And, let them know how other family members and friends will be helping with caregiving activities, such as bringing them home from school. When you cannot be with your grandchildren, talking on the phone may help them feel connected.

In addition, there may be times when you don't feel well enough to play with your grandchildren or participate in activities that you have shared in the past. Reassure them that this doesn't mean that you love them any less.

Let your grandchildren help. If you are the grandchildren's primary caregiver, you may need to ask them for help with certain tasks if you are spending time away from the house during treatment or you don't have the energy. However, don't overburden them with responsibility. Assure them that they should continue to play with their friends, participate in school activities or sports, and stay focused on their schoolwork. They need to hear that they should not feel guilty about participating in their daily activities while you are sick. These activities can help your grandchildren relieve stress and maintain a sense of stability.

Seek help from outside resources. If you feel that your grandchildren would benefit from additional support to cope with your cancer diagnosis and treatment, there may be resources in addition to your family members. These could include teachers, support groups[8], counselors[9], social workers[10], and child life specialists. Ask your doctor or nurse what resources are available.